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2066. Put a Plug in it: Using a Sustainable Interventional Radiology Service and Training Program to Combat “Brain Drain” in East Africa
Authors * Denotes Presenting Author
  1. Abdul Hamid Olushekun *; St. George's University School of Medicine
  2. Ivan Rukundo; Muhimbili University of Health and Allied Sciences
  3. Nadia Solomon; Yale School of Medicine
  4. Fabian Laage-Gaupp; Yale School of Medicine
  5. Frank Minja; Emory School of Medicine
Objective:
Many countries in Africa suffer from what has become known as “brain drain,” the loss of African physicians and scientists to other parts of the world due to a lack of infrastructure, resources, and educational opportunities in their home countries. These physicians mainly migrate in search of better standards of living, training opportunities, safety, and more stable political conditions. Nigeria for example, the country with the highest GDP in Africa, has 3.8 doctors per 10,000 population, and Tanzania has 0.4, compared to 25.9 in the United States. At the same time, over one billion people in sub-Saharan Africa are without access to interventional radiology (IR), despite its well-established advantages for numerous indications. To provide training opportunities for local trainees and desperately needed treatments to patients, a training model for countries without prior IR expertise was designed and first implemented in Tanzania.

Materials and Methods:
In October 2018, teaching teams including IR faculty, technologists, nurses, residents, and medical students began traveling to Tanzania from North America on monthly two-week trips to train local radiology residents, nurses, and technologists in IR. A two-year Master of Science (MSc) in IR was established at the nation’s main academic teaching institution, modeled after the IR training curricula in the United States.

Results:
As of August 2020, 408 vascular and non-vascular IR procedures have been performed by the first IR service in Tanzania. 76.7% were overseen by visiting faculty, while 23.3% were performed independently by Tanzanian trainees without a visiting team present. Three current fellows, two from Tanzania and one from Rwanda, began training as the first generation of IR trainees in East Africa in October 2019; five new fellows–four from Tanzania and one from Nigeria–are to commence their training in October 2020.

Conclusion:
While promoting reintegration in the home country has been suggested as a potential solution, it does not account for the fact that it is far easier to resettle in a foreign country if a trainee has spent several years training and building a network there, which is often the case for those pursuing scientific and medical education. The new MSc program in Tanzania provides IR training opportunities that were previously lacking in East Africa. Creating opportunities to stay local for higher education and specialized training facilitates trainees' ability to remain in or near their home countries and increases their likelihood to practice locally after training completion. Furthermore, establishment of IR training provides a sustainable framework of IR services, which may inspire foreign-trained African healthcare professionals to repatriate and improve the delivery of healthcare in their home countries while saving them the need to establish a service themselves and be challenged by the associated governmental hurdles and roadblocks. Retention of these physicians and repatriation of national physicians abroad thereby contributes to combating brain drain in Africa.